Reconstruction of Mandibular Defects in Superficial Granulomatous Pyoderma Gangrenosum Using Bioactive Allomaterials and Next‑Generation Cytokine Blockade
DOI:
https://doi.org/10.70577/asce.v5i3.1021Keywords:
Pyoderma gangrenosum; Mandibular defect; Bone reconstruction; BMP-2; Bimekizumab; Inflammatory diseasesAbstract
Superficial granulomatous pyoderma gangrenosum (SGPG) is an ultra-rare variant of pyoderma gangrenosum, characterized by superficial granulomatous lesions that can erode deep tissues, including the mandibular bone. Resulting mandibular defects are difficult to reconstruct due to persistent inflammation and failure of conventional grafts. To present a case of mandibular reconstruction in SGPG using bioactive allomaterials (porous hydroxyapatite + recombinant BMP-2) combined with next‑generation cytokine blockade (IL‑23/IL‑17 inhibitor, bimekizumab). Single case report of a 34‑year‑old female with biopsy‑proven SGPG who presented a 4 cm segmental mandibular defect in the right parasymphyseal region after sequestrectomy. control of inflammatory flare with bimekizumab 320 mg subcutaneously every 4 weeks, delayed reconstruction with porous hydroxyapatite allograft functionalized with BMP-2 (1.5 mg), fixation with a locking titanium plate, and continuation of IL‑23/IL‑17 blockade for 12 months. Bone consolidation was achieved at 8 months. At 18 months, the patient had facial symmetry, normal masticatory function, and no disease recurrence. Computed tomography showed allograft integration with laminar bone formation. No serious adverse events occurred. The combination of bioactive allomaterials (hydroxyapatite/BMP-2) and dual IL‑23/IL‑17 blockade is safe and effective for mandibular reconstruction in SGPG. More cases are required to establish recommendations.
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Copyright (c) 2026 Sylvia Nathalie Vélez Palma , Kevin Alexander Meneses Guaman , Alisson Lissette Plaza Alvarez , Maria Julissa Unuzungo Maza , Dario Esteban Lima Arias
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